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Managed Care
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BCBS-TN USES PREDICTIVE MODELING TO LOWER COSTS
By appropriately identifying members who would benefit from catastrophic case management, Blue Cross Blue Shield of Tennessee (Chattanooga, TN) has decreased its catastrophic case load to 10,000 in 2003 from 17,000 in 2002, a company official said.
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EDUCATING PROVIDERS IS KEY TO SENDING CLEAN, TIMELY CLAIMS
Creating a provider college, self-service models and quarterly meetings with top network providers, among other measures, helped Medica (Minneapolis) to consistently achieve claims turnaround times of 8.5 days with an accuracy rate of 98.5%.
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